Innovative Use of Brief Interventions in Emergency Department Attendees: The Incidence of Mental Health Disorders and Alcohol Consumption

Wednesday, 1 August 2012: 8:30 AM

Petra Lawrence, BN, (Hons), RN
Nursing Research and Practice Development Centre, The Prince Charles Hospital, Chermside, Australia
Paul Fulbrook, RN, PhD
School of Nursing & Midwifery (QLD), Australian Catholic University, Brisbane, Australia
Jane Fischer, BA, MSc
Drug and Alcohol Service, Centre for Drug and Alcohol Studies, Queensland Health, Brisbane, Australia

Learning Objective 1: The learner will be able to understand the use of mental health survey tools to identify mental health disorders

Learning Objective 2: The learner will be able to understand the use of alcohol audit tools to identify risky/harmful alcohol consumption


Systematic assessment of all Emergency Department (ED) presentations may identify low level mental illness and/or risky alcohol consumption. Preventative measures, if provided early, may prevent further deterioration and promote wellness.

Background: The 2007 National Health Survey revealed one in five adults aged 16 - 85 experienced a mental disorder in the previous year, however only 35% sought assistance. The potential demand for mental health care is high but is not being met by either the specialist or the general health system.Unplanned contact with the health care system via the ED offers clinician’s an opportunity to identify patients with psychiatric co-morbidity and refer them to appropriate therapy.

Study aims: To gather data regarding the incidence of low level mental health disorders and/or risky alcohol use; and determine the sample size required to trial a brief intervention and follow-up with ED attendees.


A survey designed to gather descriptive, observational epidemiological data. All eligible patients who presented to the ED during specified data collection periods were invited to participate


Participation rate was 73.3% (n = 708)

  • 966 potential participants
    • 254 refusals (26.3%)
    • 4 exclusions (0.04%)


  • Almost 70% (n=493) reported drinking alcohol.
    • 10.9% at risky/harmful levels (AUDIT)
    • 31.1% at hazardous/dependent levels (PAT)

Mental Health

  • A significant proportion experienced low level mental health symptoms
    • DASS21 (mild/moderate): depression (18.1%), anxiety (22.6%) and stress (16.7%).
    • K10 (moderate): 19.5%


  • Within the target mental health group (mild and moderate symptoms)
    • Between 44-48% reported drinking at hazardous levels (AUDIT)
    • Between 29-39% reported drinking at harmful levels (AUDIT)
    • Approximately 30% drank at hazardous/dependent levels (PAT)


Co-morbidity was apparent with positively significant correlations between mental health and measures of alcohol consumption. This group may be amenable to brief interventions.